Reducing the impact of post-traumatic stress disorder related to intensive care: a narrative review

Authors

  • Alessia Sorrenti Healthcare Professions Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy https://orcid.org/0009-0008-6899-1572
  • Jesus Francisco Javier Leon Garcia Healthcare Professions Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy https://orcid.org/0009-0004-0276-6859
  • Jasmine Zhari Internal Medicine – High Dependency Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy https://orcid.org/0009-0007-9234-3463
  • Roberto Accardi Healthcare Professions Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy https://orcid.org/0000-0001-9460-8444

DOI:

https://doi.org/10.54103/dn/28855

Keywords:

ICU diaries, ICU survivors, Post-traumatic stress disorder, PTSD, Preventive measures

Abstract

BACKGROUND: Post-traumatic stress disorder (PTSD) is a common challenge for ICU survivors, with approximately 20-25% developing PTSD within a year of discharge due to factors like medical procedures, isolation, and sensory overload.

OBJECTIVE: This review investigates risk factors and interventions to address PTSD in ICU patients.

METHODS: A narrative literature review was conducted using databases such as Medline, Cinahl, Embase, PsycInfo, and grey literature, focusing on studies in English or Italian published in the last decade. A total of 20 articles examining PTSD risk factors and prevention strategies in ICU patients were included.

RESULTS: Key risk factors identified include younger age, male gender, illness severity, mechanical ventilation, delirium, pre-existing psychiatric conditions, and prolonged sedation. Screening tools like the Impact of Event Scale Revised (IES-R) and PTSD Checklist are critical for early detection. Preventive measures, such as ICU diaries, sensory stimulation, psychoeducation, and follow-up care, are effective in reducing PTSD symptoms. ICU diaries have been highlighted as particularly beneficial for helping patients process their ICU experiences.

CONCLUSIONS: ICU patients face psychological stressors that contribute to PTSD development. Recognizing modifiable and non-modifiable risk factors is essential for targeted prevention strategies. Nurses play a vital role in early identification and intervention, significantly reducing PTSD risks. Proactive care, including psychological support and ICU diaries, is vital for improving patient recovery and minimizing PTSD prevalence among ICU survivors.

Downloads

Download data is not yet available.

References

[1] Pompili E, Biondi M, Nicolò G. DSM-5-TR : manuale diagnostico e statistico dei disturbi mentali / American Psychiatric Association ; edizione italiana della Text Revision a cura di Giuseppe Nicolò e Enrico Pompili ; edizione italiana DSM-5 a cura di Massimo Biondi; 5. ed., text revision. Milano: Raffaello Cortina; 2023.

[2] McGiffin, J. N., Galatzer-Levy, I. R., & Bonanno, G. A. (2016). Is the intensive care unit traumatic? What we know and don't know about the intensive care unit and posttraumatic stress responses. Rehabilitation psychology, 61(2), 120–131. https://doi.org/10.1037/rep0000073

[3] Rashidi, E., Razban, F., & Asadi, N. (2024). The effect of nurse-initiated diary intervention on posttraumatic stress disorder and recall of memories in ICU survivors: a randomized controlled trial. BMC psychiatry, 24(1), 158. https://doi.org/10.1186/s12888-024-05581-x

[4] Smith, S., & Rahman, O. (2023). Postintensive Care Syndrome. In StatPearls. StatPearls Publishing.

[5] Righy, C., Rosa, R. G., da Silva, R. T. A., Kochhann, R., Migliavaca, C. B., Robinson, C. C., Teche, S. P., Teixeira, C., Bozza, F. A., & Falavigna, M. (2019). Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis. Critical care (London, England), 23(1), 213. https://doi.org/10.1186/s13054-019-2489-3

[6] Warlan, H., & Howland, L. (2015). Posttraumatic stress syndrome associated with stays in the intensive care unit: importance of nurses' involvement. Critical care nurse, 35(3), 44–54. https://doi.org/10.4037/ccn2015758

[7[Badon, P., & Giusti, G. D. (2022). Assistenza infermieristica in area critica e in emergenza. Casa Editrice Ambrosiana. ISBN 9788808980076.

[8] Rosendahl, J., Kisyova, H., Gawlytta, R., & Scherag, A. (2019). Comparative validation of three screening instruments for posttraumatic stress disorder after intensive care. Journal of critical care, 53, 149–154. https://doi.org/10.1016/j.jcrc.2019.06.016

[9] Battle, C. E., James, K., Bromfield, T., & Temblett, P. (2017). Predictors of post-traumatic stress disorder following critical illness: A mixed methods study. Journal of the Intensive Care Society, 18(4), 289–293. https://doi.org/10.1177/1751143717713853

[10] Sun, X., Huang, D., Zeng, F., Ye, Q., Xiao, H., Lv, D., Zhao, P., & Cui, X. (2021). Effect of intensive care unit diary on incidence of posttraumatic stress disorder, anxiety, and depression of adult intensive care unit survivors: A systematic review and meta-analysis. Journal of advanced nursing, 77(7), 2929–2941. https://doi.org/10.1111/jan.14706

[11] Gazzato, A., Scquizzato, T., Imbriaco, G., Negro, A., Caballo Garrido, M. C., Landoni, G., Zangrillo, A., & Borghi, G. (2022). The Effect of Intensive Care Unit Diaries on Posttraumatic Stress Disorder, Anxiety, and Depression: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Dimensions of critical care nursing : DCCN, 41(5), 256–263. https://doi.org/10.1097/DCC.0000000000000539

[12] Parker, A. M., Sricharoenchai, T., Raparla, S., Schneck, K. W., Bienvenu, O. J., & Needham, D. M. (2015). Posttraumatic stress disorder in critical illness survivors: a metaanalysis. Critical care medicine, 43(5), 1121–1129. https://doi.org/10.1097/CCM.0000000000000882

[13] da Costa, J. B., Taba, S., Scherer, J. R., Oliveira, L. L. F., Luzzi, K. C. B., Gund, D. P., Sartori, G., Porto,

I. R. P., Jorge, A. C., & Duarte, P. A. D. (2019, April 18). Psychological Disorders in Post-ICU

Survivors and Impairment in Quality of Life. Psychology & Neuroscience. Advance online

publication. http://dx.doi.org/10.1037/pne0000170

[14] Lee, M., Kang, J., & Jeong, Y. J. (2020). Risk factors for post-intensive care syndrome: A systematic review and meta-analysis. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 33(3), 287–294. https://doi.org/10.1016/j.aucc.2019.10.004

[15] Wawer, E., Viprey, M., Floccard, B., Saoud, M., Subtil, F., Wafa, H., Rheims, E., Rimmelé, T., & Poulet, E. (2020). Early Detection of Patients at Risk of Developing a Post-Traumatic Stress Disorder After an ICU Stay. Critical care medicine, 48(11), 1572–1579. https://doi.org/10.1097/CCM.0000000000004551

[16] Friberg, K., Hofsø, K., Ræder, J., Rustøen, T., Småstuen, M. C., & Olsen, B. F. (2024). Prevalence of and predictive factors associated with high levels of post-traumatic stress symptoms 3 months after intensive care unit admission: A prospective study. Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 37(2), 222–229. https://doi.org/10.1016/j.aucc.2023.06.005

[17] Nassar, A. P., Jr, Zampieri, F. G., Ranzani, O. T., & Park, M. (2015). Protocolized sedation effect on post-ICU posttraumatic stress disorder prevalence: A systematic review and network meta-analysis. Journal of critical care, 30(6), 1278–1282. https://doi.org/10.1016/j.jcrc.2015.07.023

[18] Liang, S., Pak Chun Chau, J., Hoi Shan Lo, S., Chow Choi, K., Bai, L., & Cai, W. (2023). The effects of a sensory stimulation intervention on psychosocial and clinical outcomes of critically ill patients and their families: A randomised controlled trial. Intensive & critical care nursing, 75, 103369. https://doi.org/10.1016/j.iccn.2022.103369

[19] Rosa, R. G., Ferreira, G. E., Viola, T. W., Robinson, C. C., Kochhann, R., Berto, P. P., Biason, L., Cardoso, P. R., Falavigna, M., & Teixeira, C. (2019). Effects of post-ICU follow-up on subject outcomes: A systematic review and meta-analysis. Journal of critical care, 52, 115–125. https://doi.org/10.1016/j.jcrc.2019.04.014

[20] Marra, A., Pandharipande, P. P., & Patel, M. B. (2017). Intensive Care Unit Delirium and Intensive Care Unit-Related Posttraumatic Stress Disorder. The Surgical clinics of North America, 97(6), 1215–1235. https://doi.org/10.1016/j.suc.2017.07.008

Downloads

Published

2026-07-31

How to Cite

Reducing the impact of post-traumatic stress disorder related to intensive care: a narrative review. (2026). Dissertation Nursing, 5(2), 132-144. https://doi.org/10.54103/dn/28855
Received 2025-05-12
Accepted 2026-06-01
Published 2026-07-31